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Aside from barrier methods of contraception (condoms, diaphragms etc.,) there are many different contraceptive methods.
Women with systemic lupus can use many methods of contraception, such as intrauterine devices, also called IUDs, including those delivering levonorgestrel (which is progesterone). This is the case even if they have not yet had a child, or if they receive different types of treatment, including anticoagulants, cortisone or immunosuppressants. It is also possible to use implants (implantable progestins), which are a small device that is inserted under the skin, and which avoids the need to take a tablet every day, while being very effective. For tablet forms, the progestogen-only pill (POP or “mini-pill”) (desogestrel) is preferred. Chlormadinone acetate, nomegestrol acetate and cyproterone acetate are no longer recommended due to the risk of meningioma. The use of more conventional oestrogen pills can be considered in patients who have never had a thrombosis (phlebitis or pulmonary embolisms), who do not have antiphospholipid antibodies and who have quiet lupus, without clinical manifestation.
These different possibilities should always be discussed with a gynecologist, because, apart from lupus, many restrictions exist on the use of oestrogen pills (presence of genetic factors favouring phlebitis or pulmonary embolism for example).
Finally, it is quite possible to prescribe emergency contraceptives such as the morning-after pill, which contains only progestins. Contraception, whatever it may be, is essential when a treatment that is potentially dangerous in case of pregnancy is in progress (methotrexate, thalidomide, cyclophosphamide, mycophenolic acid). Similarly, when lupus is active, and pregnancy is not immediately desirable, reliable and effective contraception is required.
Various contraceptive methods are available for people living with lupus. Consultation with a gynecologist will help select the most appropriate methods, taking into account the level of activity of your lupus and the treatment in progress.
In the case of treatment with potential significant impact on pregnancy, effective contraception might be mandatory.